Factors That Influence Mortality in Critically Ill Patients with SARS-CoV-2 Infection: A Multicenter Study in the Kingdom of Saudi Arabia

Abstract

Background: SARS-CoV-2 infection has a high mortality rate and continues to be a global threat, which warrants the identification of all mortality risk factors in critically ill patients. Methods: This is a retrospective multicenter cohort study conducted in five hospitals in the Kingdom of Saudi Arabia (KSA). We enrolled patients with confirmed SARS-COV-2 infection admitted to any of the intensive care units from the five hospitals between March 2020 and July 2020, corresponding to the peak of recorded COVID-19 cases in the KSA. Results: In total, 229 critically ill patients with confirmed SARS-CoV-2 infection were included in the study. The presenting symptoms and signs of patients who died during hospitalization were not significantly different from those observed among patients who survived. The baseline comorbidities that were significantly associated with in-hospital mortality were diabetes (62% vs. 48% among patients who died and survived (p = 0.046)), underlying cardiac disease (38% vs. 19% (p = 0.001)), and underlying kidney disease (32% vs. 12% (p < 0.001)). Conclusion: In our cohort, the baseline comorbidities that were significantly associated with in-hospital mortality were diabetes, underlying cardiac disease, and underlying kidney disease. Additionally, the factors that independently influenced mortality among critically ill COVID-19 patients were high Activated Partial Thromboplastin Time (aPTT )and international normalization ratio (INR), acidosis, and high ferritin.

Comparison Between Physiological Scores SIPF, CURB-65, and APACHE II as Predictors of Prognosis and Mortality in Hospitalized Patients with COVID-19 Pneumonia: A Multicenter Study, Saudi Arabia

“…Regarding ICU mortality, our results are consistent with a multicenter study in Saudi Arabia in which 229 patients with COVID-19 pneumonia were treated in the ICU; the mortality rate was 37%. 21 Our results were lower than those of other studies. In a meta-analysis of 24 studies published in PubMed, MEDLINE, Cochrane, and EMBASE databases by May 31, 2020 (10,150 patients), the combined ICU mortality rate was 41.6%.…”

“…This is consistent with many studies that reported that critically ill patients with COVID-19 pneumonia have significantly higher D-dimer levels, which can be used as a prognostic marker for in-hospital mortality. 2 , 21 , 34 …”

Comparative Study of Vaccinated and Unvaccinated Hospitalised Patients: A Retrospective Population Study of 500 Hospitalised Patients with SARS-CoV-2 Infection in a Spanish Population of 220,000 Inhabitants

“…In this regard, both serum iron and transferrin are found to be inversely correlated with proinflammatory cytokines such as interleukin-6; thus, low serum iron and transferrin levels are associated with a poor prognosis in SARS-CoV-2 infection cases [ 15 ]. Moreover, elevated serum ferritin levels have also been linked to an increased risk of severe COVID-19 [ 16 ], ICU admission, and mortality rate [ 17 , 18 ].…”

Significant association between anemia and higher risk for COVID-19 mortality: A meta-analysis of adjusted effect estimates

“…1 showed the flow chart of related literature search and selection process. A total of twenty-three articles with 573,928 COVID-19 patients were eligibly included in this quantitative meta-analysis [ [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] ]. The characteristics of the eligible studies are summarized in Table 1 .…”